In-person Activities Research Articles

2nd Workshop in Microbial Molecular Biology

2nd Workshop in Microbial Molecular Biology

Abstract P646: American Indian Community Stakeholders Evaluate the Cardiovascular Health Curriculum Honoring the Gift of Heart Health: The Strong Heart Study

Honoring the Gift of Heart Health (HGHH) is a cardiovascular health education curriculum culturally tailored for American Indians (AI). It emphasizes adoption of cardiovascular health recommendations through lifestyle changes. The NHLBI has not revised HGHH components since 2006. Effectiveness of the HGHH may change overtime and updates may be required to influence community health behaviors. Therefore, we aimed to determine the cultural values and practices necessary for inspiring heart healthy behaviors and to make recommendations on including these values and practices in the curriculum. We used a qualitative research design and a narrative inquiry approach. Using snowball sampling, we recruited 11 AI community stakeholders in Oklahoma who participate in the Strong Heart Study. We conducted 3 focus groups with a semi-structured interview guide. We transcribed recordings and conducted a thematic content analysis (Figure 1). Participants viewed written materials as informative but the media as outdated, especially for younger generations, and suggested content ought to be dispersed through various social media. They theorized in-person activities would further educate and motivate community members to be heart healthy, thus adoption of HGHH recommendations more effective. Participants shared concerns about implementing HGHH dietary suggestions while attempting to control food costs, having time constraints, and perceiving food discussed in the program as not representative of what their communities eat. In conclusion, AI community stakeholders advise HGHH updates need to be applicable with current technology, focused on younger generations, coupled with in-person activities, and socio-economically and culturally sensitive to have the most effect. Collecting and evaluating community feedback can guide the development of appropriate updates to the HGHH curriculum. Figure 1 . Theme words identified in focus groups in colored boxes and their related code words in grey boxes.

Differences in American adolescent sport participation during the COVID-19 pandemic by learning mode: A national survey

This study aimed to examine the relation between learning mode with sport participation and compare participation prevalence in different settings by learning mode among United States adolescents during the COVID-19 pandemic. A cross-sectional, national survey was conducted by a market research company (December 2021-January 2022) among parents whose child participated in sports pre-pandemic. Parents were asked about their child’s learning mode (in-person, online, hybrid); sports participation (yes/no) during the pandemic; and participation setting (school, community, club/elite). Weighted logistic regression models examined the relation between learning mode with sport participation. Weighted prevalence estimates of participation setting were compared by learning mode. Among youth included in the analysis (n = 500; Meanage = 14.0 years), 71.0% played sports during the pandemic. Learning mode was significantly associated with participating (versus not participating) among adolescents attending school online (aOR = 0.09; 95% CI: 0.04–0.18) and in a hybrid modality (aOR = 0.30; 95% CI: 0.15–0.58) versus those attending in-person. Those attending school online (versus in-person or hybrid) had significantly lower participation prevalence in community, school, and club/elite sports. Findings may reflect parents opting out of in-person activities or schools canceling organized sport opportunities. To inform engagement strategies, research is needed to understand reasons for declined participation and extent to which participation resumed.

Factors that promote resilience for older adults and their informal caregivers during the COVID-19 pandemic

Objectives The aim of this cross-sectional, descriptive study was to characterize the impact of modifiable activities on older adult mental health during the COVID-19 pandemic and to understand the interaction between older adult behaviors and the mental health of their informal caregivers. Methods This study leveraged the National Health and Aging Trends Study and associated Family and Friends survey completed 2020–2021. Participants included 3,257 community dwelling older adults and 2,062 associated unpaid caregivers, weighted sample sizes 26,074,143 and 21,871,408, respectively. Results Older adult engagement in volunteering, religious, or group activities was associated with decreased older adult depression, as was increased walking or vigorous activity. However, online compared to in-person participation correlated with greater loneliness in older adults and anxiety for their caregivers. Finally, increased appreciation by the care recipient correlated with decreased caregiver depression. Conclusion Overall, a close interaction exists between caregiver and older adult behavior and psychiatric symptoms. Online activities are not an equivalent substitute for in-person activities during required social isolation; however, they remain superior to no participation. Further, increased walking and caregiver appreciation may ameliorate some of the harms of isolation. Health care providers should continue to promote engagement, exercise, and appreciation as ways to improve older adult and informal caregiver mental health.

A computational framework for transmission risk assessment of aerosolized particles in classrooms.

The online version contains supplementary material available at 10.1007/s00366-022-01773-9.

COVID Faces: Unmasking the Emotional Impact of the Pandemic

Background: In April 2020, most undergraduate medical education programs across the country ceased in-person activities. In the months that followed, the return to clinical care was often inconsistent, sporadic and unpredictable. As the pandemic wore on, the impact of COVID-19 on professional identity formation in medical students was an area ripe for investigation. This study reveals student perceptions of the impact of COVID-19 on their developing sense of professional identity. Methods: Students in the Class of 2021 at the Pennsylvania State University College of Medicine were invited to participate. After approval from the Institutional Review Board, participating students submitted an image of themselves wearing a mask of their choosing ("selfie") with an accompanying reflective narrative describing the impact of the pandemic on their educational experience. In addition, students submitted words to describe the self they projected (external) on the outside of a templated surgical mask and words to describe their true (internal) sense of self on the inside of the mask. Results: Common narrative themes that emerged included doubt, anxiety, fear, disconnection, loss of control, guilt, sacrifice, resilience and survival. Analysis of descriptors of internal and external aspects of the templated surgical masks revealed common themes of anxiety, fear, confusion and hope. Conclusions: This study provides a glimpse into the student experience of COVID-19 through several lenses. From the narrative perspective, students expressed elements of disconnection and doubt as well as resilience and grit. From the visual perspective, similar themes emerged from the mask descriptors. Overall, COVID-19 significantly impacted the emotional experiences of this cohort of fourth-year medical students, particularly in the context of sustained uncertainty and feelings of anxiety.

Treatment Court Family Nights: An Accessible and Adaptable Support for Families Engaging in Recovery.

While public health measures including physical distancing and stay-at-home orders have clear benefits in COVID-19 mitigation and prevention, they have provided unique challenges for individuals with substance use disorder (SUD), including Treatment Court (TC) participants. This study involved a qualitative evaluation of TC Family Nights; one series of Family Nights was conducted before the COVID-19 pandemic and the second series was adapted and held remotely due to COVID-19 distancing requirements. Several important themes emerged, including general positive experiences, accessible session logistics, naloxone training, attention to stigma, building recovery capital, group engagement, social interaction, and community action. These themes will help inform future SUD recovery education. Online recovery support events provide a new model for courts and recovery organizations that seek multiple ways to provide connection and support for their participants and families during times when accessibility is prioritized, in-person activities are discouraged, and in resource-sparse and geographically isolated communities.

Experiências de ser estudante universitário em tempos de pandemia: mudanças, adaptações e perspectivas compartilhadas

Abstract University education was severely impacted by the Covid-19 pandemic, so it is important to know students’ experiences in this context, considering the changes in their routines, difficulties related to learning processes and mental health. Four conversation circles were held with six students from different undergraduate courses at a public university in the South of Brazil, who were assisted by the Student Assistance Policy. The content of the meetings was submitted to thematic analysis. The results indicated that the changes caused by strategies for coping with the pandemic had a significant impact on the students’ mental health, exacerbating difficulties that were already experienced before the pandemic. The adoption of remote learning led to insecurities regarding academic development and the quality of professional preparation. As for the future, students’ expectations express both optimism about the resumption of in-person activities, but also apprehension about what the world and the Community will be like in the coming years. As a result, it is understood that higher education institutions should create and provide resources to prevent psychological suffering or its exacerbation, considering that the well-being of students must also be looked after as a crucial fator for ensuring that their paths within the university are as fruitful and positive as possible.

Líderes na pandemia: Contribuições para a literatura sobre liderança nas organizações em contextos extremos

Abstract Purpose: The Covid-19 pandemic triggered a crisis and required measures such as social distancing that have challenged the effectiveness of leadership theories and led some authors to suggest that the practice and theory of leadership are now standing at a crossroads. As the pandemic’s critical phase subsides and in-person activities gradually resume, this study seeks to understand how leaders faced the Covid-19 crisis and the results achieved for organizations and people. Originality/value: This work proposes a theoretical model to contribute to the literature about leadership in extreme events. We expand the model by Hannah et al. (2009) to cover elements not yet studied, considering a global, long-duration, and extreme context for which there was no previous training. Design/methodology/approach: This is a theoretical article based on the model of Hannah et al. (2009) on leadership in extreme events. The study proposes a model for leadership in extreme events by examining empirical articles on leadership during the pandemic from March 2020 to December 2022. Findings: Several leadership styles were adopted during the pandemic. However, almost all converged on mitigating the pandemic’s impact on employees, especially their emotional and psychological well-being, which was significantly affected by the threats posed by Covid-19. The study found that leaders may amplify adverse effects when communication is not clear and transparent and when business needs are priori-tized over the needs of employees.

New Lifestyles Due to COVID-19 and Behavior of Young People Attending Universities in Japan

The novel coronavirus infection (hereinafter, this is called COVID-19) broke out in 2019. I6 January 2020, positive cases of infection were confirmed in Japan, which forced the closure of elementary and junior high schools, voluntary restraint from going out based on a declaration of a state of emergency, and cancellation of events. After more than two years, the world is gradually beginning to move toward a new normal. This study focuses on young people aged between 18 and 20 years as of 2022. Specifically, the study highlighted students attending Japanese universities who were greatly affected by the COVID-19 pandemic in the latter half of their high school years and in the middle of university life. Moreover, it investigated and analyzed changes in their attitudes and behavior before and after the COVID-19 pandemic. The result confirmed that (1), and (2) a significant relationship existed between gender and awareness of the new lifestyle due to the COVID-19 pandemic. These results suggested that many students were willing to resume in-person activities online.

Prevalência e incidência da prática insuficiente de atividade física em adolescentes brasileiros durante a pandemia: dados da ConVid Adolescentes

ABSTRACT Objective: To evaluate the prevalence and incidence of insufficient physical activity in Brazilian adolescents and identify the most affected subgroups during the pandemic. Methods: This study used data from the “ConVid Adolescents - Behavior Survey”, which evaluated the behavior of 9,470 Brazilian adolescents during the period of social restriction due to the COVID-19 pandemic in 2020, through a self-administered online questionnaire. Participants were invited through a virtual “snowball” sampling procedure. Information was reported on the frequency of physical activity before and during the pandemic. The exposure variables used were gender, age group, race/skin color, region of Brazil, type of school, maternal education, financial difficulties during the pandemic, and social restrictions. Logistic regression models were used. Results: Adolescents engaged in less physical activity during the pandemic, as the prevalence of insufficient physical activity increased from 71.3% in the previous period to 84.3% during the pandemic. The incidence of insufficient physical activity during the pandemic was 69.6%. The subgroups of adolescents most affected were those who self-declared as black or with dark skin color, reported financial difficulties during the pandemic, lived in the Southeast and South regions of the country, and practiced intense or complete social distancing. Conclusion: High incidences of insufficient physical activity were observed among Brazilian adolescents during the COVID-19 pandemic. It is recommended that further studies explore periods after those analyzed to identify the behavioral dynamics of adolescents upon returning to in-person activities.

Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants.

Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal-fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. This is a qualitative research with key informant interviews. Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.

THE IHSS+ ADRD TRAINING PROJECT: BOLSTERING THE DEMENTIA CARE WORKFORCE IN CALIFORNIA

Abstract California’s In-Home Supportive Services (IHSS) program provides vital home care to low-income consumers, some of whom live with Alzheimer’s disease or related dementias (ADRD). Yet, most IHSS caregivers receive little or no training in dementia care. With the prevalence of ADRD among Californians age 55+ projected to increase 127% by 2040, reaching over 1.5 million people, the IHSS consumer population living with ADRD will likely increase at a similar rate, exacerbating the need for dementia-trained home care workers. This poster describes preliminary outcomes of the IHSS+ ADRD Training Project, a 10-week, competency-based training program, aiming to reach 600 IHSS caregivers in Alameda County, California, by 2024. All planned in-person activities switched to virtual strategies due to the COVID-19 pandemic. To date, 348 IHSS caregivers have been trained through 16 classes, with 9 classes offered in English, 3 classes in Spanish, and 4 classes in Cantonese. A quasi-experimental, longitudinal design was used to evaluate the project’s impact through pre, post, and 3-month follow-up surveys. Caregiver outcome measures included the: 1) Dementia Knowledge Assessment Tool 2, 2) Fortinsky self-efficacy scale, 3) Caregiver Self-Assessment Questionnaire, and 4) Patient Health Questionnaire-2. Preliminary outcomes trend toward significant increases in caregivers’ knowledge about ADRD and self-efficacy to maximize care they provide to consumers. While caregivers also reported slight increases in stress and depression, they expressed high levels of satisfaction with the training. Future analysis will include comparing IHSS caregiver outcomes to healthcare utilization patterns of IHSS consumers before and after their caregiver’s participation in the training.

Evaluation of Comprehensive COVID-19 Testing Program Outcomes in a US Dental Clinical Care Academic Setting

Although many academic institutions have implemented infection control and prevention protocols, including regular asymptomatic self-testing, in response to the COVID-19 pandemic, the outcomes of mandatory surveillance testing programs at academic dental institutions that offer direct patient-facing clinical care has not yet been reported. To report the findings of a comprehensive surveillance COVID-19 testing program at an academic dental institution by assessing SARS-CoV-2 positivity rates and the potential association of test positivity with individual-level characteristics such as age, sex, and role. A retrospective cohort study was conducted using SARS-CoV-2 self-testing data from a mandatory surveillance program at the Harvard School of Dental Medicine. Test results obtained between August 24, 2020, and February 28, 2022, from students, faculty, and staff members were analyzed. Testing cadence varied from 1 to 3 times per week depending on risk status. The association of individual characteristics with test positivity was evaluated with univariate analyses and a bayesian multilevel logistic regression model. Age by decade, sex, and role or position category (staff members, faculty, and students stratified by their involvement in clinical care activities), testing cadence, and testing date. Positive results from SARS-CoV-2 real-time reverse transcription-polymerase chain reaction self-tests were assessed. Of the 390 study participants, 210 (53.8%) were women. Participants were grouped by age as follows: 20 to 29 years (190 [48.7%]), 30 to 39 years (88 [22.6%]), 40 to 49 years (44 [11.3%]), 50 to 59 years (42 [10.8%]), and 60 years or older (26 [6.7%]). Test results demonstrated an overall 0.27% positivity rate (61 test-positive cases), with a peak weekly positivity rate of 5.12% in the first week of January 2022. The mean (SD) test positivity rate among those involved in clinical activities was 0.25% (0.04) compared with 0.36% (0.09) among nonclinical participants. When adjusting for all considered covariates, test positivity was significantly associated with testing frequency (3 times vs 1 time per week: odds ratio [OR], 1.51 [95% credible interval (CrI), 1.07-3.69]) and timing of the test (after vs during the Alpha wave: OR, 0.33 [95% CrI, 0.11-0.88]; and Omicron vs Alpha: OR, 11.59 [95% CrI, 6.49-22.21]) but not with individual characteristics (age, sex, and role). These findings suggest that implementing an adaptive testing cadence based on the risk status of individuals may be effective in reducing the risk of SARS-CoV-2 infection within an institution. In this study, involvement in clinical activities did not pose additional risk of SARS-CoV-2 infection compared with other in-person activities in the presence of these control measures.

Time Does Matter: Reduced Internal Medicine Clerkship Clinical Experiences Due to COVID-19.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has affected medical education in many ways.The Association of American Medical Colleges (AAMC) temporarily suspended clinical student rotations, calling for a transition to remote learning. Unfortunately, due to the heavy impact of COVID-19 in our South Florida community, medical students were not able to return to in-person activities for a significant time.During this period,students hadremote clerkship learning activities, didactic sessions, narrative projects, and small-group learning sessions, which were front-loaded using Zoom technology (Zoom Video Communications, Inc.,San Jose, California, United States) and web-based learning tools. Once in-person clinical experiences resumed, the duration of all third-year clerkships for the remainder of the year wasreduced to five weeks to allow for timely graduation.The Herbert Wertheim College of Medicine (HWCOM) Internal Medicine (IM) clerkshiphas traditionally beenan eight-week-long rotation.Other clerkships that varied from six to eight weeks were similarly reduced to five weeks.We hypothesized that the shortened duration of the IM clerkship would have negative impacts on National Board of Medical Examiners (NBME) exam performance and clerkship clinical experiences would likely be affected. Methods We compared the NBME subject exam results and end of clerkship evaluations from the Class of 2021 (CO2021) which had the traditional eight weeks of patient care, with the CO2022, which had only five weeks of in-person patient care.A T-test analysis was performed comparing performance on the NBME medicine clinical subject exam between students who completed the usual eight-week rotation versus those who completed a five-week rotation.We also evaluated the IM clerkship course evaluation and analyzed student responses and ratings to assess any areas that were statistically significant when comparing the traditional eight-week IM clerkship to the shortened five-week clerkship. Results There was no statistically significant difference (t=0.68,p<0.4951) in mean NBME subject exam performance between cohorts. Students who completed the shortened five-week IM clerkship indicated there waslimited volume and diversity of patients, which consequently affected their ability to complete all the required clinical experiences for the IM clerkship.These results indicated a statistically significant difference between the two cohorts (t =3.33, p<.001). Conclusion Students with shortened IM clerkship clinical care time (five weeks) were found to have no significant statistical differences in NBME subject exam performance compared to the traditional eight-week cohorts. However, students felt there was a decreased volume and diversity of patients, and they reported greater difficulties in completing the required clinical experiences, with diminished clinical confidence. Time does matter, and clinical time is very valuable for a student's undergraduate medical education.If another pandemic were to arise, the durationof differentclerkships should be carefully assessed and individualized, and methods to assess and reclaim lost clinical time during the advanced clinical and postgraduate years should be considered.

Automatic approach for mask detection: effective for COVID-19.

The outbreak of coronavirus disease 2019 (COVID-19) occurred at the end of 2019, and it has continued to be a source of misery for millions of people and companies well into 2020. There is a surge of concern among all persons, especially those who wish to resume in-person activities, as the globe recovers from the epidemic and intends to return to a level of normalcy. Wearing a face mask greatly decreases the likelihood of viral transmission and gives a sense of security, according to studies. However, manually tracking the execution of this regulation is not possible. The key to this is technology. We present a deep learning-based system that can detect instances of improper use of face masks. A dual-stage convolutional neural network architecture is used in our system to recognize masked and unmasked faces. This will aid in the tracking of safety breaches, the promotion of face mask use, and the maintenance of a safe working environment. In this paper, we propose a variant of a multi-face detection model which has the potential to target and identify a group of people whether they are wearing masks or not.

Coalition-In-Progress

For institutional survivors and their younger peers labelled/with intellectual disability, the COVID-19 pandemic and its related lockdowns carry over past experiences under government-directed isolation and mandatory medical interventions. The sudden convergence of past and present necropolitical ableism in labeled persons' lives colours this crisis, as we—a group of survivors, younger labeled people (who have not lived in institutions), and researcher/allies—attempt to simply stay in touch amid digital divides that cut off our once vibrant, interdependent in-person activities. No longer able to gather, and with limited Internet (or no) access, we resist social abandonment through phone calls. During phone conversations we discuss the affective contours of this time: grief over the past, loss of agency, restrictive rules in group homes, the dynamics of protest, fear sparked by public health orders, and a mix of anxiety and hope about the future. Taking this telephone-based dialogue as evidence of our lives in these times, we present a brief body of collectively written found poetry, a form of poetic inquiry composed of phone call snippets. This piece, coauthored by twenty members of the 'DiStory: Disability Then and Now' project in Toronto, Canada, offers a snapshot of coalition-in-process, keeping in touch amid a crisis that threatens our togetherness and—for some more than others—our lives. Following Braidotti, we couch this found poetry in a brief commentary on our slow, in-progress attempt to 'co-construct a different platform of becoming' with one another amid a divergence of historical and contemporary inequities.

Organic chemistry manuscript in pandemic times

In the 1990s and 2000s, several countries underwent important and significant changes in their universities. Likewise, in Brazil, due to the implementation of several government programs, there was an expansion of higher education and made possible a greater access to graduation. At the beginning of 2020, the world was threatened by COVID-19, several restrictive measures were implemented by government and private entities to contain the spread of the disease. In this way, Brazilian educational institutions were forced to temporarily suspend their in-person activities in order to promote social distancing. They soon found themselves in the challenge of implementing teaching methodological changes to continue the activities, in an emergency and remote way, since the outbreak of the disease did not stop within months and there was no prediction of when it would occur. This study aims to evaluate the performance of students at the Federal University of São João del-Rei at the Sete Lagoas campus in the discipline of Organic Chemistry, in the Food Engineering, Agronomic Engineering, Forestry Engineering and Interdisciplinary Biosystems courses in the two semesters of 2018 with 223 students and during the two semesters of the first year of emergency remote teaching (2020) with 337 students, drawing a parallel between them in order to raise the impacts of remote teaching for the discipline of Organic Chemistry.

Modeling optimal reopening strategies for COVID-19 and its variants by keeping infections low and fixing testing capacity.

Since early March 2020, government agencies have utilized a wide variety of non-pharmaceutical interventions to mitigate the spread of COVID-19 and have struggled to determine when it is appropriate to return to in-person activities after an outbreak is detected. At many universities, fundamental issues related to understanding the spread of the disease (e.g. the transmission rate), the ability of administrators to respond quickly enough by closing when there is a sudden rise in cases, and how to make a decision on when to reopen remains a concern. Surveillance testing strategies have been implemented in some places, and those test outcomes have dictated whether to reopen, to simultaneously monitor community spread, and/or to isolate discovered cases. However, the question remains as to when it is safe to reopen and how much testing is required to remain safely open while keeping infection numbers low. Here, we propose an extension of the classic SIR model to investigate reopening strategies for a fixed testing strategy, based on feedback from testing results. Specifically, we close when a predefined proportion of the population becomes infected, and later reopen when that infected proportion decreases below a predefined threshold. A valuable outcome of our approach is that our reopening strategies are robust to variation in almost all model parameters, including transmission rates, which can be extremely difficult to determine as they typically differ between variants, location, vaccination status, etc. Thus, these strategies can be, in theory, translated over to new variants in different regions of the world. Examples of robust feedback strategies for high disease transmission and a fixed testing capacity include (1) a single long lock down followed by a single long in-person period, and (2) multiple shorter lock downs followed by multiple shorter in-person periods. The utility of this approach of having multiple strategies is that administrators of universities, schools, business, etc. can use a strategy that is best adapted for their own functionality.

Digital Technologies in Orientation and Mobility Instruction for People Who are Blind or Have Low Vision

This paper investigates the tools and practices used by Orientation and Mobility (O&amp;M) specialists in instructing people who are blind or have low vision in concepts, skills, and techniques for safe and independent travel. Based on interviews with experienced instructors who practice in different O&amp;M settings we find that a shortage of qualified specialists and restrictions on in-person activities during COVID-19 has accelerated interest in remote instruction and assessment, while widespread adoption of smartphones with accessibility support has driven interest in assistive apps. This presents both opportunities and challenges for a practice that is traditionally conducted in-person and assessed through qualitative observations. In response we identify multiple opportunities for HCI research in service of O&amp;M, including: supporting a 'physician's assistant' model of remote O&amp;M instruction and assessment, matching O&amp;M instructors' clients with guide dogs, highlighting clients' progress towards O&amp;M goals, and collaboratively planning routes and monitoring clients' independent travel progress.